July 13, 2009

Lightning/ Electrical Burns and Episode 175

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Welcome to Episode 175

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Disney Monorail Incident Details from Responder

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Tip of the Week Lightning/ Electrical Burns

People deal with electricity everyday. From simple errands at home using common appliances to large scale construction projects with state-of-the-art power tools. Individuals constantly making use of electricity, especially workers, are prone to electrical injuries because of the environment that they are in and according to the National Institute for Occupational Health and Safety (NIOSH), an average of one worker is electrocuted on the job on every day of every year.

There are four main types of electrical injuries that EMTs and paramedics should be watching for in their patients. The most common shock-related non-fatal injury is a burn and there are three types. Electrical burns (from touching electrical wires), arc burns (from currents arcing through the air ), and thermal contact burns.

In relation to electricity, lightning strikes can also be a source of electrical injury. According to the US Centers for Disease Control and Prevention (CDC), approximately 100 of every 500 fatalities caused by electricity are the result of lightning strikes.

Although related, there are significant differences in injury patterns and pathophysiology. In a lightning strike there is the possibility of cardiac arrest, keraunoparalysis (transient paralysis associated with extreme vasoconstriction and sensory disturbances of one or more extremities), blunt trauma , and superficial burns.

Treatment of the electrical burn patient starts with basic care including ensuring airway patency, respiratory adequacy, managing cardiac arrest if present.Ã‚ Because of the hidden injuries caused when the current passed through the patient’s internal tissues, no assumptions should be made based on location of entry or exit wounds.

O2, IV, and ECG monitoring are where EMS treatment should begin once initial assessment and life threats have been dealt with.Ã‚ Treat visible burn injuries per EMS protocol and contact online medical control and your local burn center for specific instructions for your patient.Ã‚ A careful history of the traumatic event from the patient or bystanders may help physicians determine the level of internal injury so make sure someone takes the time to get that information on scene.

For more on managing electrical injuries, check out the links below.

eMedicine Article on Electrical Injuries

eMedicine Article on Lightning Inuries

National Weather Service: Lightning Safety

National Institute for Occupational Safety and Health

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